Background: The Cardiovascular Diseases (CVD) are the leading cause of death in the world today. Risk factors represent those factors that affect the development of CVD. We can divide them into variable (smoking, stress, alcohol) and fixed (age, gender, genetic predisposition). Objective: The aim of this article is to describe and analytically present the role of the healthcare system, and emphasize the importance of psychosocial factors in the etiopathogenesis of cardiovascular disease (CVD), also, clarify the relationship between psychosocial factors and other risk factors, emphasize the importance of prevention through CV disease management. Methods: For a better understanding, risk factors will be divided into materialistic (genetic predisposition, smoking, alcohol) and non-materialistic (psychosocial factors). A descriptive analysis of scientific papers from the Public Health Reviews of Cardiovascular Disease, analysing contents about CVD in scientific papers published in the articles stored in scientific on-line databases. The role of the health system was analyzed through three aspects: a) incidence and prevalence; b) diagnosis and therapy; c) health promotion. Results and Discussion: Incidence and prevalence of CVD range was 50% of all deaths worldwide. According to the WHO, 80% of these deaths occur in low- and middle-income countries. The mortality rate per 100,000 inhabitants in Bosnia and Herzegovina is 578, which is higher than in France and Croatia, and lower than in Russia and Turkmenistan. There are several ways to assess the risk of morbidity and mortality than CVD. The Framingham score that is normally used is good, however, its disadvantage is that it does not consider psychosocial risk factors, and it is possible that a wrong risk assessment per patient may occur. The ASSIGN and QRISK scores compensate for this shortcoming, however, these scores are only applicable in the UK because UK-specific psychosocial factors are considered. In BiH, a score is used to assess the risk of CVD mortality within 10 years, namely a score for countries with a high risk of CVD. The score takes into account only materialistic factors. Health promotion is adequately implemented if CVD management is correct. The main goals of CVD management are to prevent or delay the onset of cardiovascular disease and to reduce the number and severity of exacerbations and complications of CVDs Management includes: the individual and the family, the health care system, and the community. Conclusion: In order to properly conduct health promotion, we need to be familiar with, among other things, the risk factors for CVD and what is especially important is the interaction of risk factors with psychosocial risk factors. The negative effects of smoking, alcohol, hypertension, obesity, improper diet, lack of physical activity combined with poverty, work-related risk factors, divided society, politics, immorality and injustice greatly affect the development of CVD. Social determinants of health are an important part of the chain of causes and consequences for the development of cardiovascular disease. The dynamic connection with materialistic risk factors is pronounced. Knowledge of psychosocial determinants of health is important for the prevention of cardiovascular diseases.
Key words: CVD, Psychosocial factors in CVD pathogenesis, health promotion.
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